ezetimibe at a glance
Medicine class
Cholesterol-absorption inhibitor.
Main use
Lowers raised cholesterol, alone or with a statin depending on the clinical situation.
Taking the tablet
Swallow with water, with or without food.
When effects begin
Cholesterol may start to fall within about two weeks, although you may feel no different.
What is ezetimibe used for?
Licensed uses represented by the selected product include:
Primary familial or non-familial hypercholesterolaemia with a statin when a statin alone does not provide adequate control.
Primary hypercholesterolaemia without a statin when statins are inappropriate or not tolerated.
Reducing cardiovascular-event risk in people with coronary heart disease and a previous acute coronary syndrome, when used with a statin.
Homozygous familial hypercholesterolaemia, with a statin and diet; other specialist treatments may also be used.
Homozygous familial sitosterolaemia, alongside dietary management.
How does ezetimibe work?
Ezetimibe blocks the NPC1L1 sterol transporter in the small intestine. This reduces absorption of cholesterol and plant sterols, so less cholesterol reaches the liver. Its action complements statins, which reduce cholesterol production in the liver.
ezetimibe preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg
How to take ezetimibe
Follow your prescription instructions and continue the recommended cholesterol-lowering diet.
Swallow the tablet with water.
It can be taken with or without food.
Bile-acid sequestrants such as colestyramine must be taken separately; follow your prescriber's or pharmacist's instructions.
Do not stop ezetimibe without discussing ongoing cholesterol treatment with your prescriber.
ezetimibe side effects
Common or expected effects
- Abdominal pain
- Diarrhoea
- Flatulence
- Headache
- Tiredness
- Muscle aches
Get urgent medical advice
- Severe allergic reaction, including facial or throat swelling and breathing difficulty
- Unexplained muscle pain, tenderness or weakness, particularly if severe
- Yellow skin or eyes, pale stools or dark urine, which may indicate liver injury
- Severe upper-abdominal pain, which may indicate pancreatitis
ezetimibe in pregnancy
Ezetimibe is not usually recommended during pregnancy because human safety information is limited, although a specialist may consider it when cholesterol is extremely high. Discuss pregnancy or plans for pregnancy with your prescriber. Combination treatment with a statin is contraindicated during pregnancy under the selected product licence.
ezetimibe while breastfeeding
Evidence is limited. UK specialist advice permits cautious use while breastfeeding a full-term, healthy infant when treatment is needed, with monitoring of feeding, growth and possible gastrointestinal effects. The selected product information advises against ezetimibe during lactation and contraindicates combination treatment with a statin, so prescriber assessment is required.
ezetimibe interactions
Tell your prescriber or pharmacist about all medicines and supplements. Important interactions include:
Bile-acid sequestrants, such as colestyramine
They reduce ezetimibe exposure and may lessen its effect, so administration must be separated.
Ciclosporin
Ezetimibe exposure may rise and ciclosporin concentrations can change; caution and monitoring are required.
Warfarin, other coumarin anticoagulants or fluindione
The INR can increase after ezetimibe is added, so anticoagulation monitoring is required.
Common questions about ezetimibe
Answers are fully visible for fast scanning and source review.
Can ezetimibe be taken without a statin?
Yes. It is licensed without a statin for primary hypercholesterolaemia when a statin is inappropriate or not tolerated. It can also be combined with a statin when additional cholesterol lowering is needed.
How long does ezetimibe take to lower cholesterol?
Cholesterol may begin to fall within about two weeks, although you may not feel different.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.